Journal of General Internal Medicine

, Volume 25, Issue 3, pp 255–260 | Cite as

Family Caregivers, Patients and Physicians: Ethical Guidance to Optimize Relationships

  • Sheryl MitnickEmail author
  • Cathy Leffler
  • Virginia L. Hood
  • for the American College of Physicians Ethics, Professionalism and Human Rights Committee
Health Policy


Family caregivers play a major role in maximizing the health and quality of life of more than 30 million individuals with acute and chronic illness. Patients depend on family caregivers for assistance with daily activities, managing complex care, navigating the health care system, and communicating with health care professionals. Physical, emotional and financial stress may increase caregiver vulnerability to injury and illness. Geographically distant family caregivers and health professionals in the role of family caregivers may suffer additional burdens. Physician recognition of the value of the caregiver role may contribute to a positive caregiving experience and decrease rates of patient hospitalization and institutionalization. However, physicians may face ethical challenges in partnering with patients and family caregivers while preserving the primacy of the patient-physician relationship. The American College of Physicians in conjunction with ten other professional societies offers ethical guidance to physicians in developing mutually supportive patient–physician–caregiver relationships.


caregivers physician palliative relationships 



The ACP Ethics, Professionalism and Human Rights Committee would like to thank and acknowledge the following reviewers of this position paper who provided valuable insights and suggestions: Robert M. Arnold, MD, FACP; David J. Casarett, MD, MA; Lynn Friss Feinberg, MSW; Richard W. Honsinger, Jr, MD MACP; Carol Levine, MA; Solomon Liao, MD; Rhonda Richards; Linda Saunders; Melvyn L. Sterling, MD, FACP; and Brenda Sulick, Ph.D.

Conflict of Interest

Cathy Leffler receives royalties from Springer Publishing for: Leffler, C. Patient and medical education on complementary and alternative care: sorting it all out. In Snyder L ed. Complementary and Alternative Medicine: Ethics, the Patient and the Physician. Totowa, NJ: Humana Press Inc. 2007. Dr. Hood receives grant funding for Best Practices in Managing Hypertension Learning Collaborative, American Medical Group Association with support from Daiichi Sankyo. No other conflicts of interest were disclosed.

Supplementary material

11606_2009_1206_MOESM1_ESM.doc (106 kb)
ESM 1 (DOC 106 KB)


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Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Sheryl Mitnick
    • 1
    Email author
  • Cathy Leffler
  • Virginia L. Hood
    • 2
    • 3
  • for the American College of Physicians Ethics, Professionalism and Human Rights Committee
  1. 1.Center for Ethics and ProfessionalismAmerican College of PhysiciansPhiladelphiaUSA
  2. 2.Ethics, Professionalism and Human Rights CommitteeAmerican College of PhysiciansPhiladelphiaUSA
  3. 3.Nephrology Unit RehabilitationUniversity of VermontBurlingtonUSA

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